For people living with pulmonary arterial hypertension (PAH), frequent doctor’s appointments are vital for managing their condition. Risk assessment — an estimation of how severe a disease is, its prognosis, and life expectancy — is key for monitoring disease progression and response to treatment.

In-person healthcare isn’t always accessible or convenient. Work, caregiving responsibilities, and long travel distances are just a few examples of barriers that can prevent someone from seeing their healthcare provider in person. Fortunately, evidence suggests that accurate self-reporting can make it possible for PAH specialists to effectively assess risk remotely.

How Can PAH Risk Assessment Be Remote?

Doctors improved the ability to perform accurate risk assessment via telemedicine, or online doctors’ visits, during the COVID-19 pandemic. Since then, remote risk assessment has become more widely used for people with PAH. Remote risk assessment relies on accurate self-reporting by people with PAH, especially when measuring their functional capacity and mobility.

PAH specialists may ask for self-measurements using monitoring devices or at-home function tests.

Recent studies show that patient-reported outcomes can be an effective method to support the management of PAH. Self-reports and questionnaires can support remote follow-ups with a person’s healthcare provider, but risk assessment usually requires multiple tests, and some may need to be performed during in-person visits. Even with modern self-assessments, people with PAH should still visit their healthcare providers for tests like brain natriuretic peptide (BNP or NT-proBNP) blood tests, echocardiograms, and right heart catheterizations.

How Smartphones Can Help

Most people today have smartphones, which can be helpful tools for remote monitoring of PAH. A smartphone allows you the convenience of sending data and self-test results directly to your healthcare providers.

Additionally, some smartphone-based apps and smartwatches can collect biometric data, which may help support remote monitoring, corroborate self-test results, or establish a baseline for different parameters. Many smart devices and apps can track your heart rate, count your steps, or detect changes in your breathing.

Telemedicine may reduce missed doctor’s appointments for some people by lowering the burden and costs of travel.

Some research has confirmed that data from a smartphone app can be specifically useful for early PAH detection, PAH monitoring, and remote risk assessment. Wearable devices like smartwatches, headphones, and rings make it easy to collect this data and transfer it to healthcare providers. As our access to technology increases and new devices become available, more and more people may be able to use these apps and devices to monitor PAH.

What To Expect During Remote PAH Risk Assessment

Telemedicine appointments are typically on video chat platforms, allowing you and your doctor to see and speak with each other. These virtual visits can then be added to your medical record. If you don’t have a stable internet connection or don’t feel comfortable using new technologies, you can also have a telemedicine visit over the phone. There are many ways a physician can monitor your PAH during a telemedicine appointment.

Reporting PAH Symptoms

Clinical history and an interview with your doctor are important for monitoring the progression of PAH and for adjusting PAH therapy. Be sure to report even minor changes in your condition. Even the most subtle worsening of symptoms could be significant to your doctor and affect your current treatment plan.

Measuring Vital Signs, Function, and Capacity

Your doctor may also ask you to use home health-monitoring devices, such as smartwatches, scales, apps, and pulse oximeters, to take certain physical measurements. Some of the things a doctor may ask you about or monitor during a telehealth visit include your:

• Blood pressure
• Weight
• Oxygen saturation
• Cardiac rhythm
• Mobility or walk distance

Follow-up appointments every three to six months are key to managing PAH.

Healthcare providers may also review recent in-clinic test results, such as those from a six-minute walk test (6MWT) or an incremental shuttle walk test (ISWT). In some cases, healthcare providers might use structured or supervised remote activity tracking instead.

Does Remote Risk Assessment Really Work?

Telehealth visits aren’t new. Even before the COVID-19 pandemic, telehealth visits were scheduled between in-person visits to monitor a variety of conditions, including cardiovascular diseases. In a 2010 study, regular telehealth visits for people with heart failure reduced the rates of hospitalizations and death.

In a 2016 study, the use of wireless electronic devices that send daily information to a clinical nurse about a person’s vital signs — including blood pressure, heart rate, and weight — led to improved 180-day quality-of-life scores in participants with heart failure. Clinical trials such as these help to validate at-home monitoring visits as an alternative to standard, in-person medical center or clinic visits.

These studies provide a look into how telehealth might help people with heart diseases in general, but PAH is its own condition. Currently, research suggests that telehealth can be a helpful add-on to PAH care but shouldn’t fully replace in-person evaluations.

Even with modern self-assessments, people with PAH should still visit their healthcare providers for tests like brain natriuretic peptide (BNP or NT-proBNP) blood tests, echocardiograms, and right heart catheterizations.

Follow-up appointments every three to six months are key to managing PAH. Telehealth appointments to monitor PAH symptoms and assess risk are an effective way to update your doctor on your condition and make sure your treatment plan is working for you.

Telemedicine may reduce missed doctor’s appointments for some people by lowering the burden and costs of travel. Telemedicine can make visits more convenient and reduce any anxiety a person may have about attending doctors’ appointments.

Join the Conversation

On myPHteam, people share their experiences with pulmonary hypertension and pulmonary arterial hypertension, get advice, and find support from others who understand.

Have you used technology or telehealth to help monitor your PAH remotely? Let others know in the comments below.